Healthcare Provider Details

I. General information

NPI: 1730210022
Provider Name (Legal Business Name): WILLIAM MICHAEL HILL D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MIDDLESEX RD SUITE 2
TYNGSBORO MA
01879-1028
US

IV. Provider business mailing address

40 VIRGINIA RD
TYNGSBORO MA
01879-2349
US

V. Phone/Fax

Practice location:
  • Phone: 978-649-3304
  • Fax: 978-649-1859
Mailing address:
  • Phone: 978-649-3299
  • Fax: 978-649-1859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number15942
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: